We all do it — pick a scab, pop a pimple — but skin picking or dermatillomania becomes a serious problem when it begins to affect how you live and when it causes you real distress. For me, my feet take the worst of it. I’m not very open about my issues with skin picking; I feel ashamed and am afraid of judgment. However, I want to raise awareness of how disabling this problem can be. So, here are some ways skin picking affects me:

1. Showering pain.

When my skin picking gets particularly bad, the skin on my feet can become completely raw; the slightest touch and they will bleed. This is when showers can be excruciatingly painful. Water on red and raw skin is painful itself, but the added water pressure from the shower makes it hurt even more. At times I have had to wear plastic bags on my feet.

2. Walking pain.

My walking is affected when my feet are badly damaged. Just moving them hurts, but also having to wear socks and shoes.

3. Hiding the damage.

Compulsive skin pickers will often go to great lengths to hide their injured skin. For me this involves never showing my feet – you will never see me barefooted. I’m fortunate in that sense, as my feet aren’t too difficult to hide, but some people struggle because hands and faces can be victims difficult to cover up.

4. Random urges in public.

Urges to pick can come at any time, and in any place. I remember on one occasion I had the strongest feeling of needing to pick my feet during a class at school. I tried my hardest to fight the urge, but gave in, and took my shoe and half my sock off under the table to secretly pick away.

5. Not having a skin picking tool available.

Some people pick their skin with their fingers, other with tools and some with both. Because I bite my nails so much, I have to use objects. When I get the urge to pick and I can’t find a tool to use, my mind will not let it go. I will drop whatever I’m doing to search until I find something to use. When I can’t find an ideal object, I have resorted to strange inventions. This really shows just how powerful those impulses can be.

I can spend hours, even entire days or nights, picking at my feet. When I go into “skin picking mode” I seem to enter a weird trance-like state where time doesn’t exist and I am purely focused on what I’m doing. Heck, I’ve turned down family and friend activities because I have been in the middle of picking my skin – just wasting the time destroying my feet.

7. Body soreness from hours spent picking.

Sore skin aside, being hunched over picking for that extended period makes my back and neck ache for a long time afterward. I’m sure many people who pick other parts of their bodies can relate to skin picking causing pain in more than just the direct body part.

8. Finding blood on clothes.

After a long day, when I take my shoes off I will often find that at some point my feet have bled without me knowing and my socks will be stained. Similarly, my fingers will often bleed and I’ll be unaware until I find red marks all over my clothes or books.

9. Deliberate (or not so deliberate) skin sabotage.

Something I’ve only recently noticed I do is rub my feet while I’m wearing socks to dry out and mess up my skin. I’ve realized I’m sabotaging my skin, almost preparing it to be picked, and I can often do this for a long time without noticing. This is a huge part of compulsive skin picking — not allowing your skin to heal.

10. Conflicting thoughts

I’ve attempted to stop picking my skin countless times, and I think the reason I haven’t succeeded yet is that I’m not sure I want to stop. This is very confusing indeed! I know my behavior is unhealthy — I know I would rather not do it — but the thought of not doing it anymore brings me anxiety. Skin picking causes me pain, it causes me embarrassment and shame — but in the moment, while I’m doing it, I feel the strangest sense of calmness, order, pleasure and relief.

If you are a compulsive skin picker, you are not alone and we should not feel ashamed or embarrassed. I am working on building my confidence to not hide my feet because I don’t want this issue to hold me back. If you are not a compulsive skin picker, I hope from reading this you have learned a little about how much this can affect people. If you see someone with marks on their skin, please be mindful, please be polite and please be understanding. Skin picking is not pleasant, it’s not something people ever actually want to be doing. It’s an impulse, something that is destructive and unhealthy.